Louise Casey, the head of the social care commission in England, is set to warn at the annual national children and adult services conference on November 11, 2026, that successive governments have been "asleep at the wheel" regarding adult social care. According to report coverage by The Guardian, Casey will state that the adult social care system has developed into a chaotic patchwork of local services, effectively leaving "no one in charge."
Casey's review highlights that England lacks clear "system stewardship" for social care, contrasting the country with international peers like France, Germany, and Japan. This absence of unified leadership makes it difficult for policy to translate into practical improvements or to address varying local standards, assessment processes, and waiting times across regions.
To address these failings, Casey is calling for a "new settlement" built on decency, contribution, and a shared duty of care. The Prime Minister has accelerated Casey's review to complete next year, twelve months ahead of the initial timetable set by the government, with plans to feature a national care service proposal in Labour's next election manifesto. Under proposed funding changes, savings realized from ending the state pension triple lock in the next parliament would be used to fund free personal care based on the Scottish model, leaving individuals responsible for bed and board costs.
During her speech, Casey will also reference findings from the Covid-19 inquiry, echoing inquiry chair Heather Hallett's conclusion that adult social care was treated as an afterthought during the pandemic. The inquiry noted that more than 43,000 care home residents died from Covid-19 in the UK between March 2020 and July 2022. Casey drew on research from the Nuffield Trust and the Institute for Government, emphasizing that lasting reform will require sustained political will and clear governance rather than simple structural reorganization.
